{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T02:55:04Z","timestamp":1770778504054,"version":"3.50.0"},"reference-count":20,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8\u201333% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients\u2014127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism.<\/jats:p>","DOI":"10.3390\/life12081286","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T21:30:34Z","timestamp":1661203834000},"page":"1286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Multiglandular Parathyroid Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-0918","authenticated-orcid":false,"given":"Grzegorz","family":"Kowalski","sequence":"first","affiliation":[{"name":"Department of General and Endocrine Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Bu\u0142a","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bednarczyk","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Gawrychowska","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Gawrychowski","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00423-015-1348-1","article-title":"Sporadic multiple parathyroid gland disease\u2014A consensus report of the European Society of Endocrine Surgeons (ESES)","volume":"400","author":"Dionigi","year":"2015","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5858\/2001-125-0178-DAOTPG","article-title":"Double adenoma of the parathyroid gland: Does the entity exist?","volume":"125","author":"Baloch","year":"2001","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/00000658-199309000-00009","article-title":"Double parathyroid adenomas. Clinical and biochemical characteristics before and after parathyroidectomy","volume":"218","author":"Tezelman","year":"1993","journal-title":"Ann. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1007\/s00268-009-0022-6","article-title":"Molecular genetics of parathyroid disease","volume":"33","author":"Westin","year":"2009","journal-title":"World J. Surg."},{"key":"ref_5","first-page":"70","article-title":"The parathyroid adenoma. A histopathologic definition with a study of 172 cases of primary hyperparathyroidism","volume":"115","author":"Kimura","year":"1984","journal-title":"Am. J. Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1136\/jcp.31.7.626","article-title":"A histological comparison of adenomatous and hyperplastic parathyroid glands","volume":"31","author":"Lawrence","year":"1978","journal-title":"J. Clin. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kebebew, E., Hwang, J., Reiff, E., Duh, Q.-Y., and Clark, O.H. (2006). Predictors of single-gland vs multigland parathyroid disease in primary hyperparathyroidism: A simple and accurate scoring model. Arch. Surg., 141.","DOI":"10.1001\/archsurg.141.8.777"},{"key":"ref_8","first-page":"bcr\u20132017","article-title":"A garden of parathyroid adenomas","volume":"2017","author":"Sahli","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s00259-009-1131-z","article-title":"2009 EANM parathyroid guidelines","volume":"36","author":"Ugur","year":"2009","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"328","DOI":"10.4103\/0377-4929.120420","article-title":"Double adenoma of the parathyroid: Reinforcing the existence of this entity","volume":"56","author":"Venkatachala","year":"2013","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jamcollsurg.2003.09.012","article-title":"The clinical significance and anatomic distribution of parathyroid double adenomas","volume":"198","author":"Bergson","year":"2004","journal-title":"J. Am. Coll. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.humpath.2020.07.008","article-title":"Pathology data set for reporting parathyroid carcinoma and atypical parathyroid neoplasm: Recommendations from the International Collaboration on Cancer Reporting","volume":"110","author":"Williams","year":"2020","journal-title":"Hum. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"260","DOI":"10.5603\/EP.a2020.0028","article-title":"Primary hyperparathyroidism","volume":"71","author":"Kowalski","year":"2020","journal-title":"Endokrynol. Pol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s00423-009-0524-6","article-title":"Surgery for patients with primary hyperparathyroidism and negative sestamibi scintigraphy\u2014A feasibility study","volume":"394","author":"Thier","year":"2009","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1308\/rcsann.2017.0112","article-title":"Current predictive models do not accurately differentiate between single and multi-gland disease in primary hyperparathyroidism: A retrospective cohort study of two endocrine surgery units","volume":"100","author":"Edafe","year":"2018","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gawrychowski, J., Kowalski, G.J., Bu\u0142a, G., Bednarczyk, A., \u017b\u0105d\u0142o, D., Niedzielski, Z., Gawrychowska, A., and Kozio\u0142ek, H. (2020). Surgical Management of Primary Hyperparathyroidism-Clinicopathologic Study of 1019 Cases from a Single Institution. J. Clin. Med., 9.","DOI":"10.3390\/jcm9113540"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1007\/s00259-007-0388-3","article-title":"Scintigraphic techniques in primary hyperparathyroidism: From pre-operative localisation to intra-operative imaging","volume":"34","author":"Rubello","year":"2007","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.surg.2009.06.043","article-title":"Surgeon-performed ultrasound: A single institution experience in parathyroid localization","volume":"146","author":"Jabiev","year":"2009","journal-title":"Surgery"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"477","DOI":"10.26502\/jsr.10020102","article-title":"Benign Parathyroid Gland Tumors and their Heterogeneity","volume":"3","author":"Kowalski","year":"2020","journal-title":"J. Surg. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Shifrin, A. (2020). Advances in the Diagnosis and Surgical Management of Primary Hyperparathyroidism. Advances in Treatment and Management in Surgical Endocrinology, Elsevier.","DOI":"10.1016\/B978-0-323-66195-9.00007-8"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/8\/1286\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:13:39Z","timestamp":1760141619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/8\/1286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,22]]},"references-count":20,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["life12081286"],"URL":"https:\/\/doi.org\/10.3390\/life12081286","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,22]]}}}